Sunday, February 15, 2015

What's for breakfast?

Sometimes the easiest way to introduce a new food into an unhealthy nutrition practice is to "wedge in fiber".  My patients don't need an extra hour of food 101 and they can figure out what along the periphery of the grocery store has fiber in it-fruits, veggies and grain.  Personally I have tried to move away from cereal and bread.  I did do a gluten fast last year for about 2 months to experience what my patients go through and it was not too bad.  Took a little planning ahead but truthfully, this is mindful eating.  To have what I call a healthy nutrition practice really takes planning your meals for a day or two ahead.  If you wait and try to satisfy last minute hunger cravings, the tsunami of hormones released by the brain to hunt for quick energy sources will drive you to the closest fast food chain.  "Just this once", "I'll make up for it tomorrow", "I deserve it"......there is never an excuse good enough to trump- "Should have planned ahead".  I have Go-Bags ready to go if something comes up and I can't prep my meals for the day.  My bug-out meals are very no frills but satisfies my calorie requirements for the day and reminds me of the importance in prepping flavorful meals for the next day.

I used to move more toward "whole grain" or "multi grain" bread instead of the Wonder White Bread from my childhood, but realizing that most of the brown colored bread "grain" breads are just white breads with molasses for coloring.  Even as I pay more attention to the healthy breakfast cereals that come in smaller boxes with Non GMO or Organic labels....sugar and carbohydrate content is still sky high.

NON GMO/Organic

My son's morning pick me up

Sugar/high glycemic index foods/healthy wrapping.         Sugar/High GI/kid wrapping

One of the good premises of the PALEO diet (popularized by Lorain Cordain) is that is cuts out sugar, white flour and refined carbohydrates.  Unfortunately it also cuts out whole grains which I believe are helpful for fiber, lignans and some B vitamins.  Likewise, no beans or legumes.....of which tempe, edamame, tofu and miso are excellent sources of plant protein found in the Okinawan diet, one of the highest concentrations of centenarians on the planet.

Going to a non pulverized grain is probably easy to find since you have to work with it.  Clean and rinse, boil, then toast or sauté in oil/garlic to bring out an olive oil kinda nutty flavor with a hint of garlic.  This with a protein source (fish/egg/tofu/lean meat) makes me satiated. So regarding finding a grain Dad's oatmeal with some fruit in the am is not satisfying to me.  I am used to eating with Jasmine rice so switching over to another whole grain source is easy.  I think if you are used to eating cereal, McMuffins, Donuts, Croissants with a 20oz coffee splashed with will be a tough switch.  Bottom line is it has to start somewhere, 30-40 years of living the same way have put most Americans in the predicament of Pre Diabetes, High Cholesterol, White Coat Hypertension or the largest waistlines on the planet.  Get used to eating healthful meals and sleep will be better: get used to sleeping better and work solving skills will improve: get more efficient with work and more free time will open up: with more free time you can develop a form of recreation therapy: with more activity you won't crave crappy food. The circle of life.

Clockwise from Black=Forbidden Rice, Millet, Farrow, Tricolored Quinoa, Buckwheat, Spelt, Barley Hulled
Center =Hemp, Jasmine Rice

Sunday, February 1, 2015

Should you trust your doctor?

I remember in Family Medicine residency there was an ENT doctor who let us shadow him during his office hours.  These specialists will take care of nose and ear issues but also splinter off to do head and neck surgery (cancer).  During office hours he would have us come back to his room after seeing a patient to discuss the case......and then light up a cigarette!!  He is still alive and practicing medicine but I'm not sure if the tobacco use led to anything bad (hope not).  So comes the controversial idea, "should I listen to a doctor that looks unhealthy".   Judging someone is never good by the way they look alone...there is always a back story.  If what you uncover is someone that has an unhealthy lifestyle can decide on your own.  As for me, I have seen the best surgeons in the area display horrible manners in the operating room, throwing instruments, shouting, temper tantrums....alot of bad energy while the patient is asleep.  Also heard some counter arguments that the yelling in the operating room is for the benefit of the patient.  Bullshit!! That is adult age bullying!!  My energy healers will know the truth that practicing with poor compassion for a patient, staff, innocent bystanders....reveals true feelings/intentions from the heart.  A doctor may have outstanding surgical skills or very specialized rare problem solving but would you trust your care to a healer or an "un-healer"?

Knowing a back story, is important: to find out what the obese doctor was in weight 5 years ago, or where the smoking doctor is going for counseling.  Judging a book by its cover is poor practice but getting empowering advice from an unhealthy human seems bad practice as well.  I like an ancient saying:

Search me, O God, and know my heart;
Try me, and know my anxieties;
24 And see if there is any wicked way in me,
And lead me in the way everlasting. psalm 139: 23-24

I believe no one is exempt from living to your best potential (which starts with Thinking/Eating/Activity) but sometimes we have to be scrutinized by a "third party" and guided on living a better way -and this includes doctors.  I don't like getting check ups, but I still go to providers to make sure I am doing the best I can (to prepare for my heart attack, stroke, or cancer.....I pray it's not diagnosed until my 90th birthday but if it comes up sooner, at least I tried my best).  So ....should you take my advise about a diagnosis and start treatment-NO!.  I always invite my patients to learn about their diagnosis by watching my educational videos, asking questions, and reading from the best authors.  I invite second opinions all the time, but it has to be from someone with equal experience.  Even if I send patients to cardiologists after an ER visit, I would send to a cardiologist who went the extra mile and trained in nutrition and complementary healing.  Don't get me wrong, all MD's and DO's in the US have to pass a gauntlet of emotional distress, sleepless nights, poor nutrition, caffeine abuse and in some .....marriage failure (the reason I backed out of being a surgeon was the divorce rate of the residents was too high to risk losing my sweetheart from med school)   Medical training is to learn an ocean of diseases and treatments, then fine tune knowledge and skills to match the population we are responsible for.  Hopefully if you feel healthy, look healthy, have a strong family unit, contribute to society and get checked yearly- your doctor is expert in preventive medicine and will "lead you in ways everlasting".  But what if the doctor looking out for your future, isn't trained in preventive health care.....or doesn't update him/herself with new information.....or the information s/he gets is biased and misleading.    Then I have a problem with that.   I don't have a problem with sharing normal range test results with patients, but I do have a problem telling an obese smoker the the chest X-rays and blood tests are OK this year so everything is "all clear" till next year.   (Most patients that have bad habits, may not be willing to change at that point in time....but there will come a day in every ones life when the trigger to change present and there should be plan in place to start the emergency response-even if it just means, call when you are ready).  I have blogged in the past - if you are a hammer, everything looks like a nail.  I believe all doctors should better themselves with up to date information on the evolving horizon of nutrition and wellness.  Just getting information updates from the good looking drug reps that give free lunch is not the way.  In fact it is the opposite IMHO, the studies funded by drug companies are very biased to praise the drugs they sell.  If only the Statin companies were forced to pay for promoting a whole food mostly plant based diet/ the Ritalin companies were forced to pay for nature/relaxation therapy/ the Weight loss companies were forced to pay for adult activity retreats.  (Hey why not, we forced tobacco companies to pay for Truth advertisements and smoking cessation programs!!)

At the least, if doc listens, then they may be able to scrutinize potential problems and either design a lifestyle change or get you to the appropriate healers who can guide/construct/critique the current unhealthy trajectory.  If there is no nutrition fund of knowledge, no time to listen and no healers to "outsource care"-your on your own.  But short of the most remote portions of the US,  I have a large family of well trained, well informed modern day healers just waiting to turn you around (link to find a doc)

Friday, January 30, 2015

Emotional Accelerators

If you have a rock solid spiritual practice, the things I call emotional accelerators will catapult you to a level of peace and nirvana that mimics the bliss of nature, birth of a baby, falling in love.  On the other hand, if all you have is a solid stress response available, emotional accelerators will (by statistics) bring on early morbidity/mortality.  Humans are born with fully functioning sympathetic (stress response) and parasympathetic (relaxation response) systems.  It is in growing up, going to school, spending time with family that we cultivate both of these systems so they suit our needs as we age.  Problem is American schooling doesn't support relaxation practice-used to be in some schools we would pray (a form of the relaxation response) but now it can only be found in catholic private schools.  Detention is a way to embrace the relaxation response (quiet/solitude/reflection/writing words repetitively on the myself) but it is a punishment practice given to those with very aggressive stress response practice.

Does lack of relaxation practice hurt? theory it does.  No retrospective studies on this however  about 10 years ago a study found 80% of those diagnosed with an auto immune disease were found to have been exposed to a form of abuse in younger years.  (hints at an association between stress and disease).  Some people will listen to the ego and claim stress response carried them to be CEO, top athlete, best in school.... if you take the argument that your personal reliance on stress response is what catapulted you to the current level of society, I still disagree.  All the firefighters, police officers, military personnel, martial artists, athletes I have helped- hands down agree that the level of functioning amplifies when the relaxation response is developed.  Accuracy improves, problem solving is better under stress, anticipation and reaction is quicker, listening to body cues during competition is heightened to know when injury is about to happen.

So what are negative emotional accelerators?
-angry mob
-a vehicle (from Monday morning minivan to teenager in a loud 300+hp muscle V8)
-social media
-any weapon
-any drug
-untreated mood disorder
-terminal diagnosis (denial)

What are positive emotional accelerators?
-a rescue team
-group meditation
-arts and crafts
-falling in love
-serving your true purpose in life
-terminal diagnosis (acceptance)

To become "bomb-proof" to negative accelerators takes practice (sometimes up to several years-I am coming up on my 5th year of practice via the Chopra Center and my Integrative Medical Training and I still feel like a beginner).   Until one harnesses the infinite power of the relaxation response, I would try to avoid everything listed above as negative.  Yes, if you go through the list, you will probably be losing weight, lowering cholesterol, bringing blood pressure down, improving sleep/sex and ditching the anxiety/depression medicines.  There will be a little withdrawal from it all but the rewards are so heaven-sent once you realize what you have been missing.  Bad habits seem to accumulate inconspicuously and we become so used to them, its as if they aren't so bad (...individually!) But if you looked at accumulated damage of where you are now and where you were in younger years....very depressing.

In the corporate world its called Normalization of Deviance.  You kinda look at the dust in the corner and figure, its OK, will take care of it later.  This is what happened to the Challenger catastrophe.  That multimillion dollar project and the lives lost all because of cheap o-rings (that where thought to be "enough")   Or a mechanic that doesn't tighten the wheel lugs to proper torque....they just slowly get looser and looser until.....  The pounds, the blood pressure, the cholesterol, the sugar, the falling hair, the postponed date nights, all become lower priority.  It takes a little bit of a fast to get back to basics.  I think of it as a News Fast, a Noise Fast, a Nutrition Fast, a Negative Neighbor Fast, a Non-Activity Fast.   Just like the bible, you need to remove yourself from these things for a short time to realize the beauty of life without these crappy things.  Once you get there, your gut works better, brain thinks faster, DNA fights stronger.....just like the times of youth, impervious to everything.

Monday, November 17, 2014

How do I become spiritual?

My best response can be found in the Deepak and Oprah 21 Day Meditation Challenge November 2014 - day 14:

Hello everyone, here we are.  The end of week 2, already and may I say again, how honored Deepak and I are to have you all share in this meditation experience with us.  And I hope you feel it too, as we gather this tribe of seekers and meditators from around the world.  We continue our journey with day 14- Spiritual Manifestation.  .
So how do you know when you’re in the flow of spiritual manifestation?  Your desires arise from your core self, from a place of pure awakened consciousness, that’s how.  When you’re manifesting from your true self you’re deeply connected to what your soul came here to do.  Rather than your desires creating an outcome of constantly doing and getting more and more and more; your desires are in search of being and becoming  more.  And there’s a sense of contentment, of joy, of harmony and love that abides in everything that you do.   These outcomes are exactly what the universe is waiting to have us all manifest.  What an extraordinary gift you give yourself and to the world when you allow your deepest, truest most cherished desires to come alive and flow from you and to you and be realized.  This is what spiritual manifestation is all about. 
So today we are going to open our heart to everything that’s possible.  Wow, that’s a big opening.  As Deepak guides us into our meditation.
Congratulations on completing week 2 of our meditation experience.  This marks an important milestone.  Everyone wants to attract better things into their lives but now you’ve gone deeply into the art of desire and you know what the mechanics of manifestation truly are.  This knowledge can benefit you for the rest of your life.  The culmination of week 2 is to manifest your spiritual desires.  These include the desire for inner peace.  Direct experience of the soul and connecting with God or however you conceive of the divine.  There’s a false belief that the soul is separate from the body and that desire is there for low while spirit is high.  This separation is manmade.  As far as your true self is concerned, fulfilling your most cherished desires is totally spiritual.  In fact, this is what the spiritual path is all about.  As you reflect on what you want to manifest in your life, think of what you hope to feel when you achieve it.  If you know you’ll feel loving, kind contented peaceful nourished and safe.  Your desire has its roots in spirit because these are qualities of your true self silently awaiting to manifest.  As your consciousness awakens, the qualities of your true self awaken too.  Waking up simply means becoming more self-aware.  It is finding out who you really are.  The process is natural rather than mystical.  Open to everyone, not just saints and sages.  When you awaken by practicing meditation you’re on the path for fulfilling spiritual longing, love bliss and freedom.  Learning to live from this level of pure awareness, is known is Sanskrit as Sithi.  The word may be ancient but the goal is timeless.  It exists for you, here and now.  Encountering your soul happens without effort because your soul is just as eager to connect with you.  As we prepare to meditate together let’s take a moment to consider our centering thought:  
Fulfilling My Dreams/Fulfills My Spirit
Now let’s prepare for our meditation.    Make yourself comfortable and close your eyes.   Begin to be aware of your breath and just breathe slowly and deeply.  With each breath, allow yourself to become more deeply relaxed.  Now gently introduce the mantra;
Shreem Namah
This mantra helps to manifest abundance, that brings us closer to spiritual fulfilment.  As you repeat the mantra, feel the integration of material and spiritual abundance in your consciousness.  Repeat it silently to yourself, Shreem Namah.  With each repetition feel your body mind and spirit open and receive just a little more.  Whenever you find yourself distracted by thoughts noises of physical sensations, simply return your attention to silently repeating the mantra; Shreem Namah, Shreem Namah.  Please continue with your meditation, I’ll mind the time and when it’s time to end you’ll hear me ring a soft bell.  Shreem Namah, Shreem Namah, Shreem Namah.  Just mentally….Shreem Namah, Shreem Namah, Shreem Namah.

“All life is a manifestation of the spirit, the manifestation of love.” ― Morihei Ueshiba

Monday, September 29, 2014

How I found Integrative Medicine.

I originally flipped a coin in 1994 (graduation from Family Practice residency) to decide what my next move was to be.  The buzz then was to apply for a Sports Medicine Fellowship or Maternal Fetal Medicine Fellowship.   I had a personal "calling" to fly to Arizona and train with this white bearded guy who was teaching about nutrition and supplements.  The only catch to Andrew Weil's fellowship was you had to live in a house for 1-2 years while training with the man.   I just had a daughter and the easier path was to apply to Sports Medicine in Chicago (4 fellowships available at the time).  I was honored to be picked out of a group of docs and off I went.  So cool to learn, be the team doc for DePaul, be on the field for the World Cup, be ringside for USA Boxing, USA Wrestling, Illinois Gymnastics and be one of the docs for the Chicago Marathon.   Will always hold that year special in my life and valuable...I found out that my FP residency training was above average but yet paled in its content and training for musculoskeletal medicine and it's importance in medical disease management.
I became the Sports Medicine consultant in a large group and it was cool seeing my own FP patients and getting referrals for injury and pain.  Eventually the consults were so easy, I needed a little more challenge so decided to fix the weak link between diagnosing and treatment: the dreaded 3 page carbon copy insurance request form.  Usually it took an average of 7 days to get approval followed by an appointment with PT or ortho.  I decided to investigate Medical Acupuncture as a facilitator for pain relief while waiting for approval.  Research brought me to Joseph Helms at UCLA.  After 1 year I graduated and applied needles to my first acupuncture patient, Sheryl who suffered from chronic headaches for 10-15 years with no relief from meds and consults.  After 20-30 minutes she had NO pain!!!  For the first time in so long she had disappearance of headaches!!!  I continued with using needles scattered throughout my day for tough pain patients and boy did I have great results...I ended up doing most of my acupuncture on Saturday (my time) since the use of moxa would smell up the clinic.  Moxa is mugwort that supposedly had some "healing" properties to it.  Needles for pain; burnt herbs for healing?  Something in me was shifting.
I continued to complement my practice with this alternative medicine and at the same time this store called "Whole Foods Market" opened in Danada Square in Wheaton.  I would go there for lunch and hang out in the herb isle and watch people choosing expensive freshly made food and pouring roots and leaves out of glass containers into specially marked bags.  What kinda hippy franchise was this?!?!  Then I spotted newsletters written by Andrew Weil.  Here is this beard guy appearing back in my life.  I took some online courses for nutrition/menopause and funny, as I finished each online course, a patient would show up at my clinic with the same ailments I just read about.   I was being called to follow my dharma.  I thought I had more pressing issues with the change of administration at the hospital I was practicing in for the last 10 years.  Through a series of head butting episodes (see  my chapter "The Kick in the Ass" from Running Behind -due out fall 2015), I resigned from my position and moved to Orlando Florida.  I thought my medical career was over, eventually bills piled up and I had to look for a job.  After 18 months my restrictive covenant in IL ran out and I decided to return.   I worked a series of Immediate Care jobs (no overnight call, no hospital rounds, at the end of shift you turn your phone/pager off) but all during this time, Integrative Medicine kept pulling me back.  I had to deal with the trauma of "not being the Specially Trained Doctor with good bedside skills" and found yoga.  I ended up taking a 200 hour teacher training course with Deepak Chopra and another 200 hours with Total Body Yoga in Mundelein IL.  (couldn't get enough of this healing practice!!!)   At the right time, I received a message from a representative from The Arizona Center for Integrative Medicine asking me if I would be interested to join the fellowship.   That was how my Dharma found me again.
Since then I have been able to ease the pain of pancreatic cancer for my Mama.  Help my own healing and recovery from her loss.; find my way back to medical practice (I joined an "Integrative Group" practice in Arlington Heights 2012 -see my chapter "Quantum Moments" from Running Behind due out in 2015); and ultimately care for my Dad in his final years.  Now my calling is to set my footprint of practice in Illinois and share this with individuals, families, communities and the health profession.  I believe having a lot of hats to wear doesn't make me a weak jack of all trades who acts as a gate keeper to the world of medical drugs and procedures.  The Universe has pulled me in the direction of western medical proficient, traditional chinese medicine experience, ayurvedic healing with yoga and using food as medicine/medicine as food.   Administration has asked me, "how many hours of Sports Medicine do you want to practice?"   My answer is I cannot separate sports medicine, acupuncture, yoga, nutrition or mind body medicine into different is all part and parcel of creating lifestyle changes for people wanting to be healthy and minimize suffering.  

Wednesday, September 24, 2014

Nature Therapy

  • Dr about grounding the body by walking barefooted on the ground, on the beach, or on the lawn?

  • DrRic Saguil Hey Manny, American Indian folklore attributes improving the body's healing when surrounded by nature. On the flip side, when an individual has no practice of "grounding" then proceeds to submerge themselves in the frenzy of "tech", it acts as a gateway drug/lifestyle that throws every cell in the body into poor eating/poor sleep/ poor activity. (obesity/heart attack/stroke) This is how I force grounding into my schedule: stop by a forest preserve, place my toes in the sand, stare over a body of water or watch a sunset. I can feel the serotonin being produced/recharged by every cell. This is why I created DrRics Hiking Excursions- "force" patients and friends to disconnect with tech and reconnect with nature. (barefoot or hiking boots!)

    Please review the lecture I gave at REI:

    and the Morton Arboretum:

    for ideas on how to "force" nature back into your life.  

Thursday, July 3, 2014

Concierge vs Integrative Medicine

A Medical Insurance CFO said she understood where I was coming from when I discussed my practice and the fact that I don't enroll in and insurance plans.  Being out of network/opting out of medicare has the benefits of not being required to purchase expensive electronic medical recording systems (and the tech necessary to maintain-I spent 2-3 hours negotiating a 30 minute compliance training slide show on Sherman Hospitals website just to maintain hospital admitting privileges...that was a chunk of an office day where I could have been paying bills!!!)
She then went on to stab me in the heart by saying, she goes to a doctor like me, her concierge doctor. Then I thought....if she negotiates price points between large corporations and medical practices, sets policy for the doctors on what they get reimbursed, "wheels and deals" strategic plans to be the middle man but show a profit to her board of directors......then she herself goes outside the usual medical insurance limitations to maintain her health-what kind of message is that for the masses of people trying to decide which plan is good for their family during open enrollment while at the same time not taking too much out of the bimonthly paycheck.   (see my blog on the Duality of Healing and Healthcare)

I am not a concierge doctor.  I do not charge a retainer fee to "cherry pick" my most loyal patient and create and exclusive membership club.   I destroyed my 401 K to study advanced techniques of mind body medicine, nutrition, acupuncture, yoga instruction so I could heal myself and my patients.   I gave up a 10 year practice to break away from a Hospital in the Center of Dupage so I wouldn't be giving up more unpaid weekend time to go back and finish charts/answer phone calls and help my patients heal their suffering.   (I was told at one point that since my acupuncture wasn't reimbursed by insurance....I had to do it on my own cant charge patients over and above the negotiated prices for evaluation and treatment if an insurance contract was signed by the hospital between provider and patient.....which makes me think a concierge retainer fee is illegal)  I was working 50 hours a week, plus giving away community lecture time, I missed my daughter growing fact I don't remember much from those 10 years except eating bad food in the morning, drinking alot of coffee in the afternoon, downing beer to force sleep to come....then getting shocked in the ICU to bring down my heart rate from all the crap I was doing.

No question, the guys who do concierge medicine must have a knack for making patients want to come back and pay an annual fee over and above the co pays of insurance.  But I have yet to see any of these docs do any further training in medicine above the usual requirements for maintaining board certification every 7-10 years.  In fact most of them still refer out to the specialists, still follow standard prescription protocols, may or may not hand out nutrition information, don't use alternative medicine.   To get off my soap box, there is a benefit of going concierge.  You have one doc that knows your name, goes to the hospital to admit you, in the past they were supposed to offer going to the specialist consult alongside you (I believe that practice stopped), their back log of a waiting list to get in is supposedly short so you can get in same day.   So $1000.00 a year to insure a spot on his/her list may be worth it.  That is about the equivalent of a 12 week healthy lifestyle program with 3-4 coaches at your side.  (I medically cleared a lady for a
 Largest Loser  program who was able to get off medicine for high cholesterol, depression, high blood pressure and is now down to a body weight she hasn't experienced since that would be a good way to spend "a doctor retainer fee")

You just have to ask yourself, do you want to be in an exclusive club and see your doctor or do you want to change your life, get healthy and not have to see your doctor?